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Re: Twin Transfusion Syndrome and Needle AmnisotomyFrom: R. Daniel Braun (rBraun@IUNET.IUPUI.EDU)Wed Oct 30 07:04:38 1996
Can someone explain the physiology of how this is supposed to work to me??? My understanding of why the fluid accumulates in that one sac is that the fetus develops polyuria secondary to volume expansion and CHF because of receiving the transfusion from its twin. The other one has oligo because of volume depletion and oliguria. How does making a hole in the sac between the two reverse the floew of blood between the two???? In my granddaughters' case one had a hematocrit of 29 (oligo) and the other 92 (poly). Poly had massive cardiac hypertrophy from trying to pump sludge around. They had ultrasound (by qualified MFM) on Monday which showed little diference in growth and the next night Tues, the fundal height had incresed from 34 cm to 58 cm and there was marked oli/poly present. Poly developed late decelerations and the labor continued in spite of amniocentesis and beta mimetics and they were delivered by abd. delivery. I don't understand how this needle amniostomy would help that kind of situation. Please enlighten me.
-- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R.Daniel Braun, MD FACOG "Money will buy you a fine dog, Clinical Professor but only love can make it wag its Department of OB/GYN tail" Indiana U. School of Medicine Richard "Kinky" Friedman OBGYN.net, International Representative, U.S. @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
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